Health

Systemic lupus erythematosus (SLE) is a chronic disease involving multiple organ systems and having a variable and unpredictable course. Patients with SLE may experience significant psychological stress, and more patients with SLE than with rheumatoid arthritis require psychiatric consultations. Depression and adjustment disorders are most common in SLE. It is generally accepted that patients with SLE and similar chronic diseases benefit greatly from being informed with scientifically valid, comprehensive information about their condition. In fact, one of the main coping mechanisms for maintaining psychological integrity in the face of chronic disease is to seek information. A guidebook for patients with SLE, providing comprehensive medical information and advice on general questions and insurance, was edited and published by the authors of this article. It seemed likely that patients whose chief coping strategy involved information seeking would benefit most from this book. Changes in the knowledge held by 66 patients with SLE given the guidebook were evaluated and correlated with psychological, medical, and social parameters. Patients' knowledge of the disease improved significantly after reading the guidebook. Those with a trade school education tended to improve more than those with academic educations and those with only basic schooling, but this improvement was insignificant. Scores on psychological tests were similar before and after receipt of the book. Family relationships, self-confidence, anxiety, and similar factors did not correlate with improvement in knowledge, and no changes in psychological parameters were identified. The study suggests that all patients with SLE, regardless of education, social influences, and psychological state, can increase their knowledge of the disease when given a guidebook about SLE. (Consumer Summary produced by Reliance Medical Information, Inc.)

High prevalence of systemic disease and mortality in Asian subjects with systemic lupus erythematosus

Article Abstract:

Systemic lupus erythematosus (SLE) is an autoimmune disorder in which antibodies are produced that attack the body's own tissue; SLE can cause a variety of symptoms involving different tissues and organ systems. How this disease manifests may be related in part to ethnic origin. Chinese patients in Singapore have been observed to have more skin and nerve disease; Melanesians in New Zealand have a higher mortality and more often tend to have kidney and nerve disease, while Japanese tend to less frequently have involvement of skin, joints, and white blood cells. The medical features of SLE were studied in 26 Asian SLE patients in England who had immigrated from the Indian subcontinent; data were compared with that taken from 61 white English SLE patients. Men comprised a significantly greater proportion of the Asian patients than the white patients. Asians tended to develop symptoms at a younger age, and had significantly higher rates of kidney disease, protein in urine, and higher incidence and higher levels of antinuclear antibodies. Significantly more Asians needed treatment to suppress the immune system, and their death rate from SLE was significantly higher. These results suggest that SLE occurs more frequently, is more severe, and results in greater mortality among Asians than among whites. (Consumer Summary produced by Reliance Medical Information, Inc.)

Late onset systemic lupus erythematosus in southern Chinese

Article Abstract:

People who develop systemic lupus erythematosus (SLE) late in life may have a milder form of the disease. Researchers compared symptoms and disease severity in 25 SLE patients who developed the disease after the age of 50 and 100 who developed the disease before 50. The female-to-male ratio in the older group was 3 to 1, compared to 13 to 1 in the younger group. Older patients were much less likely to develop the typical rash but much more likely to have rheumatoid factor. Older patients had fewer complications, fewer organs involved and fewer relapses than younger patients.